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Lisa Brenner, PhD, ABPP
Departments of Psychiatry,
Neurology, and Physical Medicine and Rehabilitation
University of Colorado School of Medicine
TBI Definition
Traumatic Brain Injury - A bolt or jolt to the
head or a penetrating head injury that disrupts
the function of the brain
Not all blows or jolts to the head result in a TBI.
The severity of such an injury may range from
mild (a brief change in mental status or
consciousness) to severe (an extended period
of unconsciousness or amnesia) after the injury.
McCallister 2005
TBI - Mechanisms
Mechanism of Injury
Acceleration/Deceleration
Blast Injury
Blast injuries are injuries that result from the
complex pressure wave generated by an
explosion.
The explosion causes an instantaneous rise in
pressure over atmospheric pressure that creates a
blast overpressurization wave
www.dvbic.org/blastinjury.html
Blast Injury
Primary
Barotrauma
Secondary Objects
being put into motion
Tertiary Individuals
being put into motion
Susan O'Brien, MD
TBI -Severity
Posttraumatic Amnesia
Trauma
Encoding events
Retrograde
Amnesia
LOC
Posttraumatic
Amnesia
TIME
Injury Severity
Mild
Moderate
Severe
Altered or LOC<30
minutes with normal
CT and/or MRI
GCS 13-15
GCS 9-12
GCS<9
PTA<24 hours
PTA<7 days
PTA>7days
Common Mild
TBI/Postconcussive
Symptoms
Headache
Poor
concentration
Memory difficulty
Irritability
Fatigue
Depression
Anxiety
Dizziness
Light sensitivity
Sound sensitivity
Terrio, H., Brenner, L.A., Ivins, B., Cho, J.M., Helmick, K.,Schwab, K., Scally, K., Bretthauser, R., Warden, D.
Traumatic Brain Injury Screening: Preliminary Findings Regarding Prevalence and Sequelae in a US Army
Brigade Combat Team. Journal of Head Trauma Rehabilitation. 2009
Terrio, H., Brenner, L.A., Ivins, B., Cho, J.M., Helmick, K.,Schwab, K., Scally, K., Bretthauser, R., Warden, D.
Traumatic Brain Injury Screening: Preliminary Findings Regarding Prevalence and Sequelae in a US Army
Brigade Combat Team. Journal of Head Trauma Rehabilitation. 2009
Common Neuropsychological
Complaints
Disordered consciousness
Disorientation
Memory deficits
Decreased abstraction
Decreased learning ability
Language/communication
deficits
Poor judgment
Poor quality control
Inability to make decisions
Poor initiative
Poor depth perception
Dizziness
Common Behavioral
Complaints
Restlessness
Agitation
Combativeness
Emotional
Lability
Confusion
Hallucinations
Disorientation
Paranoid Ideation
Hypomania
Confabulation
Irritability
Impulsivity
Egocentricity
Emotional Lability
Common Behavioral
Complaints
Impaired
Judgment
Impatience
Depression
Hypersexuality
Hyposexuality
Dependency
Silliness
continued
Aggressiveness
Apathy
Immaturity
Disinhibition
Loss of interest
Anxiety
Common Behavioral
Complaints
Impaired
Judgment
Impatience
Depression
Hypersexuality
Hyposexuality
Dependency
Silliness
continued
Aggressiveness
Apathy
Immaturity
Disinhibition
Loss of interest
Anxiety